| NPI | 1558390799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS SPENCE Owner/Physician 231-935-0788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 225100000X Physical Therapist | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2012-12-08 |